Category: Maximizing Quality of Life

16 - The Benefits Of An Interdisciplinary Approach To Improving Quality Of Life And Preventing Recurrent Falls In The Home For Individuals With A High Fall Risk: A Case Report

There are a number of well -developed fall prevention programs for those identified fallers in the community.  Home based programs are often limited to those individuals who are injured during the fall, make their way through the continuum of medical care, and return home.  There is a secondary group of those who fall in the home and are not injured.  This group often relies on the support of an Emergency Medical Support (EMS) service to come and pick them up but do not transport them due to non-injury.  EMS staff will recommend that the patient contact their primary care physicians but frequently there is no follow through by patient.    During 2015, 2016 and 2017 a local Erie county  EMS was involved in 2-3 calls per day for reports of falls in the home.  Thirty-five percent of falls in the home were listed as non-injured, non-transported.


Currently, there is a lack of a standardized referral system used by health professionals and paramedics who respond to non-injured fallers in the home. There is a need for a referral system to prevent further incidence and injury, as well as improve quality of life. The purpose of this case report is to outline the benefits of a referral system that utilized interdisciplinary care to improve the quality of life for an individual who had multiple falls in her home.  In this case report, an EMS was able to appropriately identify an individual with recurrent falls. The EMS staff worked with the patient’s physician to initiate care administered by a home health agency with follow up by a Community Paramedicine Program. The interventions provided were interdisciplinary and included physical, occupational, and speech therapy, as well as therapy dog services.  Once care was completed by the home care agency, the community paramedicine program  was able to follow through with recommendations. Through these interdisciplinary efforts, the subject decreased the number of falls she had, increased her socialization, and improved her overall health and quality of life. This information justifies the effectiveness of a referral system, warrants the investigation of this referral process, and follow through as it applies to others who are at risk for further falls in the home.


Julie Hartmann

Assistant Professor
Gannon University

Dr. Hartmann is an Assistant Professor from Gannon University. She received her physical therapy degree from Marquette University in 1985, her Master in Health Education from Penn State in 1994 and her Doctor of Science from the University of Maryland in 2011. Her physical therapy experience has been primarily with older adults. She has taught the Foundations in Geriatrics course for the past 10 years. She has a strong interest in community engagement as evidenced by the presentation of balance programs and wellness programs for older adults. She has been a board certified geriatric clinical specialist since 2007. She is the Director of the Erie County chapter of the Twilight Wish Foundation, a nonprofit group who grants wishes for older adults. She is the past president of the Independent Council on Aging of Erie County. She is currently working on the development and implementation of an Elder Justice Task Force for Erie County.

Emily Kaminske

Rehabilitation Director
Visiting Nurse Association of Erie County
Erie, Pennsylvania

Emily Kaminske has been the Rehabilitation Director at the Erie County Visiting Nurse Association since 2013 She received her Master’s in Occupational Therapy from Gannon University in 2004. Although she started her career in pediatrics, she transitioned to geriatrics and has worked in skilled care as well as home care. She has developed a fall prevention program for her current home health agency and has an interest in helping older adults in fall prevention. She has coordinated and participated in community based fall prevention programs that were developed specifically for the community partner. She is certified in the Otago and Matter of Balance programs